Back To The Future

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Back To The Future


We met with the oncologist today and said he had discussed the case with his tumor board and with the past trial oncologist.

He laid out several possibilities:

Keep going with Kadcyla and see what happens with the growing (and other tumors).

Irradiate the growing liver lesion and then continue with Kadcyla

Switch over to Carbo/Alimta + either Avastin or Keytruda.  He suggests Keytruda would be the best since he suspects that while minor and asymptomatic my wife may still have the small brain lesions.  If so, Avastin has significant brain bleed risks.

He thinks that the irradiation will only provide temporary, if any, relief since he suspects there may be more than this single lesion that is growing.

So, he thinks the best course at the moment is to switch back for 3 rounds of Carbo/Alimta (which he knows worked previously) with the added Keytruda (which has been shown in some cases to have additional effect).  If it works, my wife would then go on Keytruda or ALimta/Keytruda maintenance.  Of course both the Alimta alone and the (somewhat related to Keytruda) Opdivo alone were completely non-effective previously.

So, we are back to getting what was my wife's first chemo treatment with a twist, hoping the Keytruda will add a little something.

The oncologist also mentioned the possibility of Poziotinib down the line (about like the TAK my wife took previously, but hopefully with less side effects).

My wife is having an MRI this week (to confirm or deny the brain lesions) and a CT scan to see the current status of the lesions after the latest treatment and see if anything else is growing.

Once more.....back into the breech.  I guess if there is one good point, it will get my wife off of any microtubule poisons for a few months, so hopefully the neuropathy will improve a little.

MRI Positive

The MRI confirmed that the brain lesions are present and active - they are very slow gowing (about 40-50% growth after 12 months) - with a few more likely small spots.  So, Avastin is not an option, and my wife starts on the Carbo/Alimta/Keytruda mixture next week.

Wife, non-smoker, dx 4/24/15 adeno NSCLC stage IV. HER2 Exon 20. 6x Carbo/Alimta; effect. 9/15 Alimta maint; ineffect. 11/15 - Opdivo; ineffect. 4/16 - ptK7 trial; effective 1.5 yr. 9/17 Gemzar; effective 16 mo. 8/18 -TAK788 Trial. 10/18 start Abraxane. 7/19 start Kadcyla.

Jim C Forum Mod...
Jim C Forum Moderator's picture
MRI positive



I too am sorry to hear that the trial drug wasn't effective, but I'm hoping for a great response from carbo/alimta/keytruda. It seems that quite a number of patients who have responded well to previous lines of therapy get a benefit from each new regimen.


We just saw our little grandsons a couple weeks ago, and I heartily agree with Janine's sentiment!


Jim C Forum Moderator


JanineT Forum M...
Scohn, I'm so sorry to hear



I'm so sorry to hear your wife has to change treatments and the trial drug wasn't so helpful.  As I recall chemo was quite helpful for her but I don't recall if keytruda was in combo with alimta/carbo.   Hopefully the combo will give a good hit to the tumors without too much added neuropathy.  My husband just started taking gabapentin again.  He goes on and off it in 3 or 4 month cycles which gives the side effects a chance to subside, then starts taking it again with a bit or relief. 


I understand the smell of grandbabies is quite therapeutic.  :)


All the best of hopes,